A4416 – Ostomy pouch, closed, with barrier attached, with filter (1 piece), each
HCPCS Level II code · A codes: Transportation, Medical & Surgical Supplies, Miscellaneous & Experimental
HCPCS codeA4416
- Long description
- Ostomy pouch, closed, with barrier attached, with filter (1 piece), each
- Short description
- Ost pch clsd w barrier/filtr
- Pricing indicator
37Ostomy, tracheostomy and urological supplies- Medicare coverage
CCarrier judgment – coverage decided by the Medicare contractor- BETOS category
D1FProsthetic/Orthotic devices- Added
- January 1, 2004
- Last change
- January 1, 2004 – No change
Frequently asked questions
What is HCPCS code A4416?
A4416 is a HCPCS Level II code for ostomy pouch, closed, with barrier attached, with filter (1 piece), each.
Does Medicare cover A4416?
The HCPCS file lists coverage code C: Carrier judgment – coverage decided by the Medicare contractor. Coverage and payment also depend on local coverage determinations and the patient’s plan.
Nearby A codes
- A4408 – Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each
- A4409 – Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each
- A4410 – Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each
- A4411 – Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each
- A4412 – Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each
- A4413 – Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each
- A4414 – Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each
- A4415 – Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each
- A4417 – Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each
- A4418 – Ostomy pouch, closed; without barrier attached, with filter (1 piece), each
- A4419 – Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each
- A4420 – Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each
- A4421 – Ostomy supply; miscellaneous
- A4422 – Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each
- A4423 – Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each
- A4424 – Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each
Source: CMS HCPCS Level II quarterly file, October 2026. Reference only – check payer policy before billing.